Breastfeeding at work poses unique challenges for the mother who wishes to provide breastmilk for her child at home. Most states in the US have laws protecting a mother's right to pump, however, certain circumstances can make this difficult. Employers of more than a certain number of employees must provide a private space, other than a bathroom, for a mother to pump, and provide a refrigerator for storage of breastmilk. A hands-free pumping bra and a nursing shirt can make this much easier, and a mother could even continue to work during a pump break.
One of the primary difficulties begins with the lack of paid maternity leave in the United States. Most women are given only six weeks, unpaid, under the Family and Medical Leave Act. Six weeks is the bare minimum for a woman to recover fully from childbirth, blood loss, and establishing both a milk supply and bond with her newborn baby. Many mothers, particularly those with cesarean or assisted births, need much longer to truly be back on their feet. Babies up to three months of age drink roughly 20 ounces of milk in the 10 or so hours it takes the average woman to get ready for work, commute, and then an 8 hour work day. A normal nursing pattern for a six week old baby is 1-2 ounces every 2 to 3 hours. To replicate this production, the working pumping mother often finds herself needing to pump four times in an eight hour day. The feasibility of so many pumping sessions depends on the job and supervisor in question.
Many mothers experience a lower output with the pump than they do when nursing their babies. This does not in any way indicate a supply issue. There is an important hormonal interplay between a mother and baby, even between the baby's mouth and the nipple. It is essential that the flanges of the pump fit well and don't cause blisters, and that they make a good seal against the skin. Massage, with or without heat, before and during a pumping session can help stimulate let down. Galactogogues such as oats, brewer's yeast supplements, fenugreek, and the prescription drug domperidone can all help boost supply. An internationally board certified lactation consultant can help with the use of these methods. Most women have a greater output for a double electric pump. These are covered under many insurance plans as durable medical equipment. Pumping both breasts at once provides more stimulation and often a second let-down can be accomplished with one.